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SU0002681 (2)
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2600 - Land Use Program
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SA-99-53
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SU0002681 (2)
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Entry Properties
Last modified
10/28/2020 3:59:53 PM
Creation date
9/6/2019 10:10:11 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0002681
PE
2633
FACILITY_NAME
SA-99-53
STREET_NUMBER
19171
Direction
E
STREET_NAME
MELLO
STREET_TYPE
AVE
City
RIPON
ENTERED_DATE
10/31/2001 12:00:00 AM
SITE_LOCATION
19171 E MELLO AVE
QC Status
Approved
Scanner
SJGOV\wng
Supplemental fields
FilePath
\MIGRATIONS\M\MELLO\19171\SA-99-53_VR-99-02\SU0002681\MISC.PDF
Tags
EHD - Public
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t" Or t <br /> 4 <br /> J11L '7 <br /> v J <br /> Q � <br /> V <br /> �tatr of Tatifornio <br /> jBepartment of Social �$ertim <br /> Facility Number: 390305260 <br /> Effective Date: , 09/07/87, Total Capacity: 12 ' o <br /> Expiration Date: 09/06/88 <br /> In accordance with applicable provisions of the Health and Safety Code of <br /> California, and its rules and regulations, the Department of Social Services, hereby issues <br /> GALVEZ• JOSE; .,MAMUYAC• FLORENTINO E MA. IMMACULAD <br /> to operate and maintain a ADULT RESIDENTIAL <br /> Mum of Varitilu <br /> TOWN E COUNTRY GUEST HOME <br /> 2829 S. D STREET r <br /> STOCKTON CA 95206 <br /> This License is not transferable and is granted solely upon the following: <br /> AMBULATORY ONLY. AGES 18-59 YEARS. , <br /> 09Ay4rxNOW MIX <br /> Complaints regarding services provided in this facility should be directed to <br /> DEPT SOCIAL SVCS• COM CARE LIC 916 920-6855 <br /> FRED MILLER <br /> Deputy Director, Author d Representative Issue Data 0 <br /> Community Care Licensing Division of Licen ng Agency <br /> LIC 203A(1,871 ouauC <br /> POST IN A PROMINENT PLACE <br />
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